Year one of COVID-19 pandemic in India: Effect of lockdown and unlock on trends in keratoplasty at a tertiary eye centre

Purpose:To describe the impact of lockdown and unlock phases of the COVID-19 pandemic on keratoplasty trends at a tertiary eye care center in India.Methods:This cross-sectional hospital-based study included 6,277 patients presenting between March 25, 2017 and March 31, 2021. The data of the patients who underwent keratoplasty during the lockdown and unlock phases were compared with the respective periods in the previous three years before COVID-19.Results:During the year one of pandemic, there was a 29.46% decline in the total number of keratoplasty performed at the institute compared to previous year’s annual numbers. The patients undergoing keratoplasty decreased by 90.28% (28/288) of pre-COVID-19 volumes during the lockdown phase. This was mainly because of a 40.6% reduction in the proportion of patients requiring interstate travel. There was complete recovery in the number of patients undergoing keratoplasty to 129.27% (184/142) of pre-COVID-19 volumes by March 2021. This gradual incremental trend was seen across all types of keratoplasty in Descemet stripping endothelial keratoplasty (135.29%), penetrating keratoplasty (117.6%), therapeutic keratoplasty (122.22%), anterior lamellar keratoplasty (150%), and Descemet membrane endothelial keratoplasty (141.18%) by March 2021 with the gradual ease of lockdown regulations. The eye bank affiliated to the institute saw a 55.44% decline in donor cornea collection and an increase in utilization rate from 58.12% in previous years to 83.78% in year one of the pandemic. The overall eye bank donor cornea collection recovered to 86.96% (627/721) and tissue utilization increased by 109.99% (455/414) by March 2021.Conclusion:The first year of the COVID-19 pandemic saw an overall reduction of 29.46% of the patients undergoing keratoplasty at the institute. There was a gradual and incremental increase in all types of keratoplasty in the unlock phase, which surpassed the preceding years’ monthly numbers in February and March.